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 NEWS
January/06/2007
Surgical treatment in
paraplegia survey:
Cross-anastamosis in paraplegia below D9 started to give
results. The last documented case operated 1 year ago in a patient from Israel came
to the clinic 3 weeks ago. ECS and EMG performed showed that there is
starting innervation of Th 11 and 12. The patient's lower limbs muscles
became bulky and he could contract the lower abdominal muscles and some
movements in the pelvic girdle. Crude sensation descended down to the
inguinal level both sides. If you are more interested in this topic,
click here!
March/08/2007
Tuberculosis of the
spine
In the last 2 years the incidence of
tuberculosis of the spinal column is becoming more frequent and having
different clinico-morphologic picture. This phenomenon is alarming sign
as the residual of the use of dirty bombs and several radioactive
materials in the surrounding dirty wars in the region. For demonstration
click here! and
here!
20-AUGUST-2007
SIEMENS Digital C-arm is implemented and
functioning in the Shmaisani hospital.
30-AUGUST-2007
The Inomed ISIS Highline neurophysiologic
navigation system start to work at the operating room.
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16.
30-APRIL-2007 AMAL ADNAN AL-AZAB 36 YEARS
RESIDUAL AFTER EXCISION OF GIANT CLIVAL MENINGIOMA LEFT
CLIVO-TEMPORAL WITH LEFT FACIAL PARALYSIS
Anamnesis
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The patient came to the
clinic 21-April-2007 complaining of complete
paralysis of the left facial nerve with
deafness. |
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The patient was operated by
me
15-January-2006 for giant clival meningioma
with involvement of the left tentorium and
massive hyperostosis of the left temporal bone.
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MRI and CT-scan performed
17-September-2007 showing no recurrence.
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Considering that the facial
paralysis is complete within 17 months after the
first surgery, the patient sent to ECS and EMG,
which confirmed complete non-function of the
left facial nerve. |
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The left hypoglossal nerve
was exposed and the left facial nerve was
drilled off the canal for 10 mm depth and
the hypoglossal nerve was sharply cut just
before the emergence of the ansa cervicalis.
It was rotated upward and direct anastamosis was
performed between the 2 nerves. |
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Smooth postoperative
recovery. |
Comments:
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So as to avoid cosmetic
deformity, the tip of the mastoid was kept
intact, using osteotomes, which was returned
back at the end of the operation and fixed to
the muscle attachments above and below, avoiding
by that the formation of postauricular cavity. |
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Considering the absence of
recurrence of the tumor and more than 1 year of
waiting for the nerve to recover, without
results bridge anastamosis was suggested. |
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Fig.-1: The anatomical
relationship of the facial and hypoglossal
nerves. |
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| Fig-2: The anastamosis
performed. |
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Fig-3: The tip of mastoid
returned. |
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